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Cholesterol confusion
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keepingactive posted:
I recently received the results of my annual lipid test, and I seem to have an unusual profile. My HDL is very high, my LDL is very high, and my Trigylcerides are low.
HDL 111
LDL 202
Triglycerides 63
I have been a vegetarian for 50 years and am very physically active. I am small, 5'1'', and weigh 88 pounds. I am turning 60 next month. There seems to be little I can do to make lifestyle changes that would improve cholesterol levels, unless I eliminate all dairy and eggs (I eat so little of them now) I take no medication, and I think I'm in good health. I don't know what to do. I am reluctant to take statins, because I have no diagnosed cardiac problem, and am concerned about side effects.
Any suggestions? Should I see a specialist?
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bobby75703 responded:
I think you are wise to be "reluctant to take statins since you have never been diagnosed with cardiac problems." I never understood the logic in treating a person for a disease they didn't have.

If you are curious as to what the inside of your arteries look like, ultrasound is low cost and risk free. It can look inside your neck, Heart valves, and leg arteries.

Prescribing a statin to healthy people based upon a cholesterol number, in hopes of preventing heart disease in the future is all a silly wild guess.

Eliminating eggs would probably have little to no effect on your serum cholesterol levels. Nutritional science has come a long way in the last 20 years, and the old 1970's theory that eating an egg raises cholesterol and causes heart disease is dead and buried. Eggs are good for you, like all things in moderation. They are one of nature's super foods.

If I were in your shoes and wondered if I had any cardiovascular disease, I would get myself checked out with ultrasound. Easy, painless, low cost, and no radiation risk.

Cholesterol levels are a very poor predictor of heart disease, but its sells very well and makes customers for life.
 
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iride6606 responded:
There is much discussion concerning statins in subjects that are otherwise healthy with the exception of high cholesterol. let's look at your numbers, your LDL is way too high, that's been backed up by study after study. What is curious is your high HDL as well so what you really want to look at is your cholesterol ratio. If it's under 4.5 you're probably good. Having said that, today the medical profession will always treat the high LDL first. There can be side effects to statins, but they are rarely if ever permanent and very minor and relatively rare. In fact they are safer than most antibiotics and even Ibuprophen.

The thought that some here will make that being proactive to prevent a disease by taking a drug is not a good idea is usually slanted against statin use and not an overall sound principle, If one has risk factors that redispose them for a poor outcome, why would you not be proactive? First, if your cholesterol is as high as yours is, there is an issue with your body over producing LDL as only about 10% of your LDL comes from diet. Your liver is producing too much and the meds will control it. Also, as you age it will become a bigger issue. An ultrasound is not going to show how healthy the arteries in your heart are, only an angiogram will do that and unfortunately there is not necessarily a relationship between arterial plaques in the neck and legs to the arteries in your heart.

Let me know if I can provide any links to back up what your high LDL means.
 
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keepingactive replied to bobby75703's response:
Thank you so much for your response. The two responses I received show the dilemma I face, since the opinions are so different. I appreciate your feedback.
 
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keepingactive replied to iride6606's response:
I appreciate that you took the time to respond. Certainly you've given me some information to consider.
 
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billh99 responded:
You have an unusual lipid panel.

Do you have a family history of heart disease?
Do you have sisters/brothers/parents that can give your their lipid panels?

If you don't have a family history of heart disease and have family members with similar panels then you might have a normal healthy variant.

On the other hand if you have a very strong family history heart disease you might want to serious consider statins. Or at least do more investigation.

The risk of cholesterol seems to be more related to the number of particles with cholesterol and not the amount of cholesterol. And some HDL cholesterol is of a type that is not a protective.

There are some advanced lipid test that help show the risk of unusual lipid patterns. They are NMR and VAP.

There is blood test PLAC ( Lp-PLA2) that is an emergent marker for cardiac risk http://blogs.webmd.com/cholesterol-management/2009/08/markers-of-cardiovascular-risk-plac-test.html

You can also get CT calcium scan (Cardio Scan). Typically these are not covered by insurance and can cost several hundred. But some places they are done as a "public service" can be had for $50.

A Preventive Cardiologist can help look at these and help evaluate your risk.

And a lipid specialist can help make sense of your cholesterol and possible treatment. http://www.learnyourlipids.com/ Look under Get Help.
 
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keepingactive replied to billh99's response:
Thank you so much for your help. I'll discuss the possible screening test with my doctor and a referral to a specialist. I also appreciate that you mentioned that Preventive Cardiologists and Lipid Specialists exist. I have been wondering about which type of specialist to see.
I do not have a strong history of heart disease, although my father had a minor heart attack when he was quite elderly. My siblings' lipid profile is simmilar to mine, but my numbers are higher.
 
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Crab44402 responded:
If I were you, I would do two or three things before I panic.

1) Ask your doctor to schedule a retest since laboratories and their employees do make mistakes.
2) Ask your doctor to explain to you what diagnostic significance your clearly atypical results have if any.
3) Ask for the explanation be printed so you can study its meaning on websites like this one.
4)Report back to this blog when you have done the above. I think we would be interested in your findings.


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